免疫治疗时代可切除的鼻窦黏膜黑色素瘤： upfront手术与新辅助治疗
Resectable Sinonasal Mucosal Melanoma in the Immunotherapy Era: Upfront Surgery vs. Neoadjuvant Therapy.
作者信息
Salem Aya F, Chen Melissa M, Williams Michelle D, Swanson David M, McQuade Jennifer L, Amaria Rodabe N, Hanna Ehab Y, Bishop Andrew J, Farooqi Ahsan S, Guadagnolo B Ashleigh, Su Shirley Y, Mitra Devarati
机构信息
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Neuroradiology Department, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
出版信息
Head Neck. 2025 Feb 5. doi: 10.1002/hed.28098.
OBJECTIVE
We aim to evaluate outcomes for patients with resectable SNMM treated in the immunotherapy era.
METHODS
Thirty-seven patients with resectable SNM were identified using our institutional database between 2016 and 2023.
RESULTS
Patients receiving neoadjuvant Ipi/Nivo (46%, n = 17) were more likely to have disease involving the sinuses and/or the skull base (71% vs. 35%, p = 0.05). The overall response rate to Ipi/Nivo was 24%. Two-year LRFS from the start of therapy was 63%, and from the end of local therapy was 78%. Two-year PFS was 49%. The patients who received Ipi/Nivo with evidence of response (n = 4, 24%) had better PFS (2-year PFS 100% vs. 15%, p = 0.02) and LRFS (2-year LRFS 100% vs. 31%, p = 0.08).
CONCLUSIONS
Outcomes for resectable SNMM patients continue to be poor in the immunotherapy era. In the context of selection bias, neoadjuvant Ipi/Nivo was not associated with better outcomes in all-comers. However, those with evidence of response to Ipi/Nivo had better prognosis.
目的
我们旨在评估在免疫治疗时代接受可切除性鼻窦鼻腔恶性黑色素瘤（SNMM）治疗的患者的预后情况。
方法
利用我们机构的数据库，在2016年至2023年期间识别出37例可切除性SNM患者。
结果
接受新辅助伊匹单抗/纳武单抗治疗的患者（46%，n = 17）更有可能出现鼻窦和/或颅底受累疾病（71%对35%，p = 0.05）。伊匹单抗/纳武单抗的总体缓解率为24%。从治疗开始计算的两年局部区域无复发生存率（LRFS）为63%，从局部治疗结束计算为78%。两年无进展生存率（PFS）为49%。接受伊匹单抗/纳武单抗且有缓解证据的患者（n = 4，24%）具有更好的PFS（两年PFS为100%对15%，p = 0.02）和LRFS（两年LRFS为100%对31%，p = 0.08）。
结论
在免疫治疗时代，可切除性SNMM患者的预后仍然较差。在选择偏倚的情况下，新辅助伊匹单抗/纳武单抗对所有患者而言并未带来更好的预后。然而，那些对伊匹单抗/纳武单抗有反应证据的患者预后较好。
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